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Johannes Maximilian Wagner, Felix Reinkemeier, Christoph Wallner, Mehran Dadras, Stephanie Dittfeld, Marius Drysch, Alexander Klaus Sogorski, Maxi von Glinski, Marcus Lehnhardt, Björn Behr, Mustafa Becerikli

• Patients with diabetes suffer from poor fracture healing. Molecular reasons are not fully understood and our previous gene expression microarray analyses of regenerating bones from mice with type 2 diabetes (db\(^{−}\)/db\(^{−}\)) revealed accelerated activation of pathways concerning matrix metalloproteases (MMPs). Thus, we picked out the pathological MMP acceleration as a target for profound gene expression analyses and additional therapeutic intervention in the present study. In the first part, gene expression of ECM degrading proteinases and inhibitors was investigated three and seven days postoperatively. \(\it Mmp3\), \(\it Mmp9\), \(\it Mmp13\) and gene expression of MMP inhibitor \(\it Timp2\) was significantly higher in regenerating bone fractures of db\(^{−}\)/db\(^{−}\) compared to wild type animals. \(\it Timp1\) and metalloproteinase \(\it AdamTS4\) showed no differences. In the second part, we locally applied a single dose (1 \(\mu\)L of 5 \(\mu\)M solution) of the broad-spectrum molecular MMP inhibitor Marimastat on tibial defects in db\(^{−}\)/db\(^{−}\). We performed immunohistochemical and histological stainings seven days post operation. Impaired bone healing, collagen content, angiogenesis, and osteoclast invasion in db\(^{−}\)/db\(^{−}\) were restored significantly by application of Marimastat compared to PBS controls (\(\it n\) = 7/group). Hence, local intervention of bone defects by the molecular MMP inhibitor Marimastat might be an alternative therapeutic intervention for bone healing in diabetes.